Individual
DAWN LYNNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA, LMT
Contact information
Practice address
1226 BERLIN ST, WAUPACA, WI 54981-1991
(715) 258-5521
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4978-27
WI
225700000X
Massage Therapist
11007-146
WI
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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